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606 The American Journal of Nursing 

group of patients ; 4 hours and 57 minutes in the medical group and 
4 hours and 39 minutes in the surgical group. 2 In the light of this 
standard, it is easy to judge how far short we fall in nursing require- 
ments in most of our hospitals. None of the hospitals in New York 
City reaches this standard, two show as high an average as 4.8 hours, 
but there are some as low as .6 of one hour per patient in 24 hours. 3 
The municipal hospitals, because of a niggardly policy of the city, 
fall much below the above standard, but even our best hospitals are 
considerably below. 

It is with this in view that the statement can be made that the 
bed capacity alone does not indicate the availability of hospital 
facilities. Hospitals with a nursing standard falling so much below 
the requirements for adequate nursing as many of them do should 
not consider themselves able to run to full capacity. This leads one 
to emphasize the immediate need of ampler maintenance funds rather 
than of additional facilities when the hospital situation of a large 
city like New York is considered. 



IN LABRADOR 

By Josephine S. Lewis, R.N. 
Rome, Georgia 

I HAD dreamed of Labrador since I was a wee youngster for I 
had heard my father tell of a man who had come from England 
to help those isolated people not only from a medical standpoint, but 
from a social and economic one as well. That man the world knows 
today as Dr. Wilfred T. Grenfell. I wanted to see that country, to 
serve it if only in a small way, and now since that experience has 
become a memory, I want to give a brief account of it for others who 
may be interested. 

We sailed from Quebec on the Labrador, which is about one 
hundred and twelve feet long and twenty-six feet wide. She has 
space for fifteen first-class passengers, while there were thirty on 
board. 

We managed to crawl down the gangway which literally stood 
upon end, as it was low tide. When we reached the deck we found 
a poor fisherman's wife sitting on a pile of rough lumber with five 
children about her and an infant one month old in her arms. She 

2 Miss Greener described in detail in the February, 1921, issue of the Modern 
Hospital the study as it was carried out at Mt. Sinai Hospital. 

3 This hospital has a considerable proportion of chronic patients. 



In Labrador 607 

said, "It is so hot here," and it certainly was. The baby was securely 
wrapped in red flannels and "just a cotton quilt over its face for a 
covering." It was scarlet and had regular periods of suffocating, 
but " 'tis the way of the coast" to care for an infant. The rough 
lumber, which almost covered the deck, belonged to an Episcopal 
minister who was taking it with him to build a church somewhere on 
the north shore. In one spot chicken crates were piled with their 
contents of crowing roosters, quacking ducks and squeaking guineas. 
These served as our deck chairs during the loading. 

When it came time to retire, four of us found ourselves in the 
same stateroom. All I can say is that the carpenter who constructed 
it was not only a genius, but must have been ambidextrous as well. 
I concluded that I would leave it to my companions and let them retire 
upon the installment plan. I attempted to sleep outside. Never had 
I known that so small a boat could have so many angles and curves. 
I tried them all, and finally curled around the smokestack, where I 
remained until three-thirty. 

Twenty stops were made between Quebec and Harrington and 
each place seemed more interesting than the last, for the north shore 
of the St. Lawrence is chiefly populated by the French, but at not a 
few places we saw both Eskimos and Indians. We generally anchored 
outside and all the small boats of the village would come out to load 
and unload our cargo. Passengers were quickly exchanged, a hasty 
"bon jour" the whistle blew and we were off for the next port. We 
were four days making the trip and had delightful weather most 
of the time. 

Everyone was out early for we wanted to see it all. The Lauren- 
tian Range was covered with snow almost all of the way. We finally 
saw Harrington, — far away on a rocky promontory was the wireless 
mast with the operator's tiny white house close by, and it was not long 
before the Harrington group was spread out before us with its many 
long, low islands, three of which — the only ones inhabited — were 
dotted with small white houses. 

The community of Harrington is situated just off Cape Whittle 
along the north shore of the Saint Lawrence about seventy five miles 
west of the straits. To one accustomed to other climes the landscape 
is striking. It has a solemn and austere beauty. Although on the 
islands nature forbids trees, shrubbery, and almost grass, the ragged 
and undulating rock of somber hue, dotted with patches of moss and 
eroded with scars of ice in ages past, presents a variety and beauty 
of its own, blending fittingly with the skies and waters of this 
northern panorama. It is barren and bleak and isolated beyond 
description, but not only its inhabitants, but many of its volunteer 



608 The American Journal of Nursing 

workers think there is no other place quite so attractive. The com- 
munity proper is nestled in a little cove close by the sea. It consists 
of forty families who attend two churches, an Anglican and a Pres- 
byterian. There is also a mission hall where public gatherings are 
held. The hospital x is a two and a half story frame building with 
a capacity for fifteen beds, as well as facilities for housing the nursing 
personnel and help. The resident physician has a cottage near by 
where he and his family live. The hospital was equipped better 
than I had anticipated, including an operating room and reasonable 
facilities for examinations. Among its other belongings were a cow, 
chickens and dogs. The cow and chickens were not only a great 
benefit, but were as well an object of perennial interest to the com- 
munity at large for they were the first of their kind which had 
appeared upon the islands. 

To me the dogs created no end of fascination and fear. They 
are large, beautiful, shaggy, and usually white. They are never 
known to bark, but sit on their haunches with their heads turned 
heavenward, jaws relaxed, and howl for hours. Of all weird incan- 
tations there is nothing like it except more Eskimo dogs. They 
generally chose 2 a. m. under my window for their conventions. At 
times it was rather trying and one was almost driven to using the 
Army phrase, "Snap out of it," but the Eskimo dog is invaluable to 
the inhabitants. When on night duty I naturally did not mind it so 
much, but the patients would often offer a complaint, calling out, 
"Oh, sister, what a won'erful noise them dogs is makin'." 
"Won'erful" was a form of superlative which they applied to any and 
all conditions whether a beautiful or a cold or a stormy day, whether 
a sense of joy or pain or sorrow. It was always "won'erful." 

Now as to our work and the class of patients. The latter were 
nearly all fishermen and their families and the work consisted of 
everything from maternity cases to plaster casts. One of the things 
which made a- profound impression upon me was the large number 
of tubercular chest and bone conditions, due to lack of proper nour- 
ishment and unfortunate housing and clothing. So our duties were 
not in specialising. It was the care of an expectant mother or that 
of a tubercular patient with casts and appliances, a case of starvation 
or a child suffering with the after effects of the "flu." Some days 
we were busier than others, as when an operation was on hand or 
when a maternity case was to come off. If it were in the hospital, 

1 This is one of six hospitals maintained by the Grenfell Association. The 
others are at St. Anthony (the home of Dr. Grenfell), Battle Harbor, Indian 
Harbor, North West River, and Pilley's Island. Nursing stations are maintained 
at Forteau, St. Lewis Bay, and Flowers Cove on the West Coast of Newfound- 
land.— Ed. 



In Labrador 609 

well and good, but if it were in the home, that was another story. One 
home I remember well. I was called at 4 a. m. by the resident nurse 
who asked if I wished to go out "to assist in an obstetric case." 
"Anywhere if I can be of service," I replied. I crawled out and 
dressed quickly. It was only a short distance and I followed the 
instructions to avoid the marshes by skirting the water's edge. I 
was warmly greeted at the fisherman's cottage and was ushered into 
the room where lay the expectant mother. As she was suffering, I 
said more in sympathy than for information, "Have you a great deal 
of pain?" She looked at me with her clear blue eyes and replied, 
"Oh, not too bad." That too is a coast expression. 

I was surprised to find the home so immaculately clean — small 
rooms with low ceilings, but everything in order. It seemed like a 
big doll's house rather than a fisherman's cottage. The little woman 
had to be taken to the hospital, carried on a stretcher by the doctors, 
and there her baby greeted the world soon after. 

I have previously described the poverty of the soil along the coast 
and it must be remembered that the winters are long and severe, the 
first snow coming in October and lasting until April or even June. 
The entire harbor is frozen over and travel is by dog teams hitched 
to komatiks from island to island and over to the mainland, more 
than five miles distant. It is from the mainland that the year's supply 
of fuel (wood) is brought by these same dog teams. This land is cut 
off for seven months of the year from communication by steam with 
the outside world. 

I do not mean to give the impression that the sun never shines. 
On the contrary, when there are clear sunshiny days in summer 
with a wonderful blue sky overhead, I cannot imagine a more ideal 
climate. There are many such days, but the cloudy, cold, foggy ones 
outnumber them. And such fog — it can come and go so quickly that 
it only adds to the mysterious fascination of the country, while the 
actinic rays of the sun are so intense that the briefest exposure 
results in a burn. 

The Labrador diet is most limited, — principally fish. In winter 
one can say that it is the diet, for with it they have only bread, with 
molasses for sweetening, and rice which they cook in a phenomenal 
cement form and which they call "puddin'." Their diet is restricted 
because the climate prevents the production of fruits, vegetables and 
domestic animals. All vegetables, fruit and milk must be brought 
in cans by steamer and must be purchased by coin or trade. Each 
family provides itself as its more or less limited purse may permit. 
The hospital endeavors to maintain a reasonable supply of food, a 
privilege which is not enjoyed by all along the coast. 



610 The American Journal of Nursing 

The sole enterprise and means of subsistence is that of the great 
cod fisheries, which are, I believe, the largest in the world. So in the 
hospital the chief topic of conversation would be, "Are ye gittin' many 
fish?" or "Sister, 'tis a fine day fer dryin' fish." A patient would 
peer out of the window, gazing into what seemed to be space, when 
of a sudden his face would light up and he would remark, "I see 
Bill Mack's schooner comin' round the point." "Where?" I would 
ask. "Oh, I can just see the top o' her mast," would be the reply. 
That they could distinguish anything upon the water at any time 
was always a source of wonderment to me. They could tell the size 
of the boat, how many people and fish on board, whence they came 
and if she were having a "fair wind," with such accuracy that I won- 
dered if they could tell how many shillings the skipper had in his 
pocket. 

Our port was almost the first English speaking community up 
from Quebec and to hear them drop their "h" was ever amusing. 
Their cheerfulness, gratitude and patience were a continual inspira- 
tion to us. They always addressed us as "Sister," and no matter 
what they asked for or what they received it was "Please, sister," or 
"Thank you, sister." Courtesy and politeness were innate in them, 
even in their isolation. There were many pathetic illustrations of 
their simplicity and ingenuousness. One patient of whom I inquired 
if she had ever seen beans growing, brightened up and said, "Oh, yes, 
I has seen beans grow. I put them in a can once in the house and they 
growed all round the window. They was not much to eat, only to see." 
Another poor soul, who seemed just awaiting the summons, had a most 
annoying cough and a worn out haggard look — hard work, poverty and 
lack of recreation had left their imprint upon him. When I looked 
at his chart I was shocked to find that he was only forty-four. I asked 
him one day, "Tom, where do you live?" "Oh, in the little house 
you sees in the cove. Me and me brother lives there together. We 
owns it in partnership, he owns half and I owns the other half. He 
is married and I am not, but we meals together." I said, "Does he 
ever come to see you?" "Oh, yes, sister, dat be him on top o' dat 
chair" (pointing in the direction of the chair) "last night." One 
might have thought he was referring to a crate of oranges or a basket 
of potatoes. At another time I took him a small white flower of 
cottony texture and said, "Tom, what is the name of this?" "Oh, 
sister, I spose there is a name fer it, but I jest calls 'em flowers." He 
was always, always satisfied and grateful for the least service. He 
recovered from the cough and is back "fishin' " again. When I sailed 
he came rowing out and called to me, "Oh, sister, I jes comes out to 
say goodbye. God bless you and come back again." 



In Labrador 611 

While I have given an abridged description of my experiences 
and observations in Labrador, there is so much of humanity, pathos, 
life and fate that volumes might be written. If I have made clear 
to others the character of these people and their conditions of living, 
I shall have accomplished much. They are not crude and uncivilized 
as many have imagined. They may be rough and untutored, but 
they are industrious, hardy, kind, patient, clean and sturdy. Crime 
is practically unknown. They come primarily from the same stock 
as our American ancestors, but like flowers struggling on a barren 
soil, their development has been retarded by adverse circumstances 
and environment. 

It is for these people that the International Grenfell Association 
maintains along this coast, stretching for hundreds of miles along the 
Gulf of the Saint Lawrence and the bleak Atlantic from Newfound- 
land northward a number of centers where hospitals and medical 
facilities are provided, schools, orphanages, industrial training plants 
and cooperative stores. This is done not as a charity, but as a means 
of rendering these people self-supporting and to bring to their doors 
some of the advantages enjoyed in other lands. A large portion of 
the help in this movement is volunteer and funds are contributed by 
every continent. 

Our lives have been made richer by contact with the Labrador 
folk and our association with the other workers. While we may have 
given to them, in return we have seen the vision of faith, sincerity, 
gentleness and simplicity. They are as the little children, "for of 
such is the kingdom of heaven." We all aspire to make our lives 
useful to our fellow man. I am ready to serve them again at any 
time and under any condition. My experience with them has but 
accentuated the impression I gained when in France during the war, 
that it is service to humanity, no matter in what portion of the globe, 
which leaves with us a lasting sense of satisfaction. 



THE last report from the treasurer of the Delano Memorial Committee states 
that the present status of the fund is $9,054.18 — a gain of approximately 
$2,500 since the first of February. 

One item shows a contribution from the Student Nurses of the Indiana Uni- 
versity School of Nursing, of $112.00. It is believed that an effort should be 
made to interest the student nurses in this memorial and therefore in the work 
of the Red Cross.